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General NPI Number Information
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NPI Number | 1306037221
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Entity Type | Organization
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Legal Business Name | PHYSICIAN HEALTH CARE SYSTEM, LLC
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Dates
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Enumeration Date | 08/06/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 7401 N UNIVERSITY DR SUITE 105
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City | TAMARAC
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State | FL
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Zip | 33321-2979
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Country | US
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Telephone | 954-722-5353
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Fax | 954-722-0132
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Provider Business Mailing Address
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Address Line | 7800 W OAKLAND PARK BLVD SUITE E-214
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City | SUNRISE
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State | FL
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Zip | 33351-6741
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Country | US
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Telephone | 954-318-6590
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Fax | 954-318-6599
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Authorized Official
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Title or Position | CEO
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Name | MR. JOSEPH DI CAPUA
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Credential |
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Telephone | 954-318-6590
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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